Brianne Peltz, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

79757 Issued in MT

Practice address

202 Conway Dr Ste 200
Kalispell, MT 59901-3153

Phone

(720) 848-0000

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalispell Regional Medical Center IncGroup PAC ID 5294644381, 422 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krmcmedicalrecords@krhdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kalispell Regional Medical Center Inc

  dba Logan Health Medical Center

  • General Acute Care Hospital
  • Kalispell, MT
  • NPI 1417945627
  Medicare reassignment Care Compare group
• Kalispell Regional Medical Center, Inc

  dba Logan Health Imaging- 1111 Baker

  • Radiology Clinic/Center
  • Whitefish, MT
  • NPI 1073362463
  NPD
• Kalispell Regional Medical Center, Inc

  dba Logan Health Imaging

  • Clinic/Center
  • Kalispell, MT
  • NPI 1093477176
  NPD
• Billings Clinic

  dba Billings Clinic Hospital

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1265478291
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1437243763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CONWAY DR STE 200",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CONWAY DR STE 200",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013153",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTZ",
        "first_name": "BRIANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "1947",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MT",
            "license": "79757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81936524",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "202 Conway Dr Ste 200",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Rob K Perkins, MD

• Surgical Physician Assistant in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Surgical Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.